If your employer provides Group Health insurance, bear in mind that these plans vary widely in cost and in what they cover.
Chances are that you’re not aware of these facts about Group Health plans:
- Your plan doesn’t necessarily cover you. Employers are not required to provide Health coverage to all workers. What’s more, they can tailor benefits to specific groups of employees as long as they make clear distinctions between the groups — for example, covering full-time employees, but not part-timers.
- Your health habits could affect your premiums. Employers are well aware that the better care that their workers take of themselves, the less they’ll have to pay in health care costs – and the lower their premiums. According to one recent nationwide survey on the cost of Group Health plans, more than two in three businesses offer employees financial incentives for healthy lifestyles – for example by discounting their portion of the plan premiums. On the other hand, a growing number of businesses are setting penalties (premium surcharges) for employees who smoke, are overweight, have high cholesterol levels, etc.
- Your family might not have coverage. Although most companies provide benefits for their employees’ dependents, they have no legal obligation to do this. More and more businesses that do cover dependents are reducing their premium subsidies for this coverage. If an employee’s spouse has Health coverage available through their own job, some companies are adding a premium surcharge or removing the spouse from the plan.
- Pregnancy might not be covered. Although the federal Pregnancy Discrimination Act requires companies with 15 or more employees that have Group Health plans to pay for pregnancy-related expenses on the same basis as other medical conditions, the law does not apply to smaller businesses. Some states may require these firms to cover the costs of pregnancy. For the record, Group Health plans provide the main source for maternity coverage – a nationwide survey in 2009 found that only 13% of individual Health plans available to 30-year-old women provided maternity coverage.
- You’re paying a growing percentage of the premium. According to a nationwide survey, average total health care cost per employee should reach $11,664 this year, a 5.9 % hike from 2011. The average employees will pay $2,764 of these costs (including premiums), up 9.3 % from 2011 – and a hefty 40% higher than the 2007 figure. However, most workers don’t realize the total cost of Health insurance – until they lose their job and have to pick up the tab themselves.
If you have any questions about Health insurance for you and your family, just get in touch with us.